One of the most dangerous oncological diseases known to modern medicine is Hodgkin's lymphoma. Malignant processes affect the lymphatic system. The disease got its name on the initiative of WHO in 2001, but cancer itself was described as early as 1832. It was in honor of the author of those works, the English doctor Hodgkin, that the disease was named. Alternative names - granuloma, Hodgkin's disease.
Basic information
Hodgkin's lymphoma is a cancer in which the nodes of the lymphatic system grow. In these places atypical cells, lymphocytes accumulate. The progress of the pathology is accompanied by a failure of division, maturation of beta-lymphocytes capable of producing antibodies. Atypical neoplasms can enter the bloodstream, spread throughout the body, they accumulate in different parts of the body. As soon as a new part of the body is infected, the division processes lead to the appearance of another neoplasm.
FeatureHodgkin's lymphomas - localization in a system covering the entire human body, since there are nodes in various areas of the body. From medical statistics it is known that most often neoplasms are observed in the area of the reproductive and respiratory organs, bones.
Types and classification
Doctors divide all cases into five large groups. The most common is nodular sclerosis. Hodgkin's lymphoma in this form in the predominant percentage of cases is well treated. The current is assessed as relatively favorable.
A slightly less common form is lymphocytic. It is known from medical practice that most patients have a high chance of recovery.
If a person suffers from immunodeficiency syndrome, there is a risk that he will develop a mixed cell Hodgkin's type. It occurs somewhat less frequently than the two types described above, proceeds aggressively. Modern approaches to therapy are relatively ineffective, so the disease can be treated with great difficulty.
In old age there is a risk of detecting lymphocytic depletion. It is known from statistics that such a malignant process is more often detected only closer to the tragic end - at the fourth stage or even the fifth.
Finally, the fifth variety is nodular Hodgkin's lymphoma with a predominance of lymphoid processes. Among patients with this disease, there are significantly more men. Up to 80% of cases can be detected at the first stage, the maximum - the second. If the disease is detected early, there is a certain chance of a successfulcure.
How to notice?
Symptoms of Hodgkin's lymphoma include overgrowth of lymph nodes. The easiest way to notice this is in the groin, on the neck and in the armpits. At the very beginning, the pathology is similar to the appearance of foci of inflammation. The patient is disturbed:
- heat;
- sweats worse at night;
- weight loss for no apparent reason;
- weakness, fatigue;
- itching of skin areas;
- pain under the ribs on the right or left.
Patients feel overwhelmed, there is no strength even for the usual things that were not particularly difficult before.
Symptoms of Hodgkin's lymphoma include an increased concentration of white blood cells in the circulatory system. If the primary manifestations were ignored, a strong pain syndrome in the bones gradually joins. The cancer process gives metastases found in a variety of tissues and organs. As the lymph nodes grow, they put pressure on organic structures nearby. This causes specific symptoms:
- dry cough;
- shortness of breath;
- back pain;
- tingling in the region of the heart;
- bloody coughs.
To clarify what kind of disease it is (Hodgkin's lymphoma or something else), they do a number of tests, laboratory and instrumental studies. Take tissue samples for biopsy. The described disease is diagnosed if specific Reed-Sternberg cells are detected in the materials.
Features of the disease
Currently doctors are notknow what causes Hodgkin's lymphoma. Scientific studies on this issue have been carried out for more than a year, but reliable, confirmed information has not yet been obtained. This significantly complicates the formulation of the risk group, therefore, the primary manifestations of the disease should be known to everyone without exception in order to raise the alarm in time and come for an examination to the doctor in order to establish which symptoms of which disease are bothering.
In the initial stage of Hodgkin's lymphoma, swelling appears in the area of the lymph nodes. These areas are given by pain. If this phenomenon worries, then it's time to go to the doctor for a detailed analysis. More often swelling is formed in the perineum, armpits, on the neck.
In some cases, the disease manifests itself:
- stomach pain;
- neoplasms in the abdomen.
Explaining to the patient what kind of disease it is - Hodgkin's lymphoma, the doctor will definitely tell you that it often at first proceeds without any severe symptoms at all. It is easy to confuse an oncological disease and a common cold, with which patients come to the therapist if ARI cannot be cured by the usual means for a long time. If the doctor sends for specialized examinations, it is important to pass them as quickly as possible - the sooner the pathology can be established, the better the patient's prospects will be.
Diagnosis
If there is a suspicion of Hodgkin's lymphoma in adults, children, the doctor examines the patient, makes a list of all he alth complaints,examines the history of the disease, sends for x-rays. Pathology is not inherited, it is impossible to get infected with lymphoma from a patient.
The final conclusion can only be drawn up based on the results of the biopsy. The procedure is carried out under local anesthesia. A small needle is used to remove tissue samples from the patient's body. The material must be taken from a swollen lymph node. To control the procedure, you must use a CT scanner.
As can be seen from the reviews compiled by experts, Hodgkin's lymphoma can only be established if a biopsy is performed according to all the rules. The options are:
- delete the entire node or its element;
- getting tissue samples with a wide needle;
- using a fine needle.
If the diagnosis is confirmed, additional tests are ordered to determine the stage of Hodgkin's lymphoma. 4 (5 on some less common classifications) certainly has the worst prognosis for treatment, but only the beginning of the disease is likely to be cured.
To clarify the state, assign:
- CT;
- MRI;
- X-ray;
- bone marrow biopsy;
- ultrasound;
- blood study.
Stages of development
Certainly, the worst option is the detection of Hodgkin's lymphoma at stage 4. To understand what this means, one should be guided by what signs a case is attributed to a particular step.
At the first stage, the oncological disease is localized in the group of lymphaticnodes nearby. These can be knots in the crotch on one side or on the neck, but also on one side only.
If two groups of lymph nodes are simultaneously involved in the process or the disease has gone further, but all areas of localization are either above the diaphragm or below it, the case is classified as the second stage.
The third stage is said if at the same time atypical cells are localized in the lymph nodes above the diaphragm and below it.
The most difficult case, and therefore the worst prognosis, is stage 4 Hodgkin's lymphoma. At the same time, atypical cells will be present not only in the lymphatic system, but also spread to the internal organs, infected the bone tissue.
Classification and manifestations
In some patients, fever starts at night, sweating becomes more active, weight decreases sharply. In this case, they say that the case belongs to the category "A". The second option, class "B", is diagnosed if the listed symptoms are absent.
It is known that the disease can develop both in an adult and in a child. There are two options: the classic scenario or nodular sclerosis. Hodgkin's lymphoma in both cases is an extremely dangerous disease. It is more likely to develop if the patient is already infected with the Epstein-Barr virus.
Lymphoma is known to be more common in boys over the age of five but younger than fourteen. If a child's brother or sister has lymphoma, the baby is more likely to develop it. The manifestations of the disease in children and adults do not differ.
What to do?
Treatment of Hodgkin's lymphoma is determined by the form, type of disease, stage at which it was discovered. Much depends on the patient's well-being, the presence of other pathologies. The main goal of the therapeutic course is absolute remission, that is, a complete victory over the symptoms and signs. If it is impossible to achieve such a state, a partial remission is established, when it is possible to take the tumor under control, to prevent harm to other tissues and organs.
The treatment of Hodgkin's lymphoma is a complex of techniques:
- medicines;
- radiotherapy;
- surgery.
If it was possible to detect the disease at the very beginning of its development, radiation and chemotherapy will be sufficient. In later cases, additional immunotherapy is required. With the help of irradiation, atypical formations in the affected organic tissues can be effectively destroyed. All areas where doctors suspect there are cancers are being irradiated.
Chemotherapy is the use of drugs that can inhibit the vital activity of atypical cells. Some drugs are available in the form of tablets, while others are intended for injection. To improve the prognosis, several drugs have to be combined. A specific program is chosen by a professional, evaluating the features of the case.
Immunotherapy is the use of drugs to stabilize the immune system.
Sometimes folk recipes are used. They cannot be called the main treatment, but such compositions, being successfully selected, allow stimulating the immune system,slightly improve the patient's condition. Of course, they cannot replace the main course.
A well-chosen program helps prevent the recurrence of Hodgkin's lymphoma.
Folk methods against cancer
Healers and healers can offer several recipes to alleviate the condition of a patient with Hodgkin's lymphoma. The photo below shows what the plant looks like, from which the most effective preparations are prepared - this is aloe vera, which is widespread in our country. Syrup is prepared on its juice, it is used for food. The drug is harmless, strengthens the immune system, increases the body's resistance to various pathological agents, prevents recurrence of diseases against the background of a weakened natural defense.
It is believed that viburnum decoctions will bring benefits. For cooking, not only berries are used, but also tree branches. Useful infusion on calendula inflorescences. Two cups of boiling water are taken for a couple of spoons of petals, insisted for at least 30 minutes and consumed. You can replace your usual teas with calendula infusion.
Many healers are convinced that in case of cancer an indispensable element of treatment is chaga, birch mushroom. The greatest effect will be from using it in food at the beginning of the disease. It is believed that the product can slow down the reproduction of atypical cells, relieve pain. Chaga infusion is used before meals three times daily. Dosage - tablespoon.
Disease: defeated?
From statistics it is known that many patients with Hodgkin's lymphoma face relapses of the disease. Ascompletion of the therapeutic course of the patient left on the account. You will have to regularly come to the clinic for examination by a professional. If the malignant processes suddenly become active again, the doctor will be able to notice this at an early stage, which means taking adequate measures. The sooner a relapse was established, the better the prognosis.
Currently, successful Hodgkin's lymphoma patients are considered to need check-ups every two months. With half the frequency, the patient is given computed tomography. These measures keep the condition under control.
Features of food
To increase your chances, you should eat right. With Hodgkin's lymphoma, dairy products are indicated, and most of all - sour-milk. Will have to give up:
- bold;
- fried;
- sweets;
- savory dishes.
Absolute ban is imposed on alcohol, carbonated, fast food.
To support the body's defenses, you need to provide an influx of vitamins and minerals with food. To do this, the diet will have to diversify with an abundance of fresh fruits and vegetables.
The patient is shown cereals and soups, oats and buckwheat, beets and garlic. It is recommended to cook dishes with cheese and carrots.
Substantial treatment is the key to success
The classic approach to curing the disease is a combination of chemotherapy and radiation, although in some cases one method is sufficient. In order for the course to be as effective as possible, but bring the patient as little inconvenience as possible, over the preparation of the programa group of doctors of different speci alties. A team of specialists with a high level of qualification can create an optimized, sparing program, taking into account the specifics of the case. At the same time, the stage of the disease and the area of localization of atypical cells, the dimensions of the lymph nodes, comorbidities, and the patient's condition as a whole are taken into account.
If it was possible to identify the disease at the very beginning, it is quite possible that only radiotherapy will already be enough. In practice, doctors prefer to add a course of chemotherapy even at the onset of the disease to ensure a better prognosis. If Hodgkin's lymphoma is detected at a late stage, chemotherapy is indispensable. We'll have to prepare mentally: dosages will be high.
Features of the disease
It was mentioned above that the disease was first described back in 1832. Initially, scientists believed that there were two peaks of development; the first falls on the age group from 15 to forty, the second affects people over the age of fifty. At present, the information has been clarified using the most effective drugs, tools and techniques, of which the most significant is immunophenotyping. It was revealed that the disease does not have a second peak or it is rather weak, and cases that were previously attributed to Hodgkin's lymphoma are actually large cell non-Hodgkin's.
Before, Hodgkin's lymphoma belonged to the number of incurable diseases. Currently, up to 85% of patients either recover completely or achieve stable remission. Successful therapy requirescompliance with two basic conditions:
- disease detection at an early stage;
- correct selection of a treatment program and strict adherence to it.
Risk group
Scientists believe that the likelihood of developing a malignant process is higher for people whose immune system is weakened. This can be triggered by a variety of factors:
- HIV infection;
- organ transplant operation;
- drug therapy;
- diseases that depress the immune system.
Higher risk of developing cancer due to glandular fever caused by the Epstein-Barr virus.
Nuances of the disease
Doctors note: Hodgkin's lymphoma does not develop instantly. In some, the symptoms become relatively clear within a month; in others, the condition gradually changes for the worse over a period of six months or even more. Manifestations are different for different people. In childhood, lymphoma is often disguised as a cold, but there is also the opposite situation, when the manifestations of a cold are mistaken for atypical cells and the patient is sent for a long study.
If a persistent increase in the size of the lymph nodes of the cervical-supraclavicular region is detected, while the general state of he alth is normal, the probability of an oncological process is estimated at 70%. On the study, the nodes show themselves to be mobile, to the touch - elastic, dense. Pain in the area is possible, but this condition is not necessary.
If it was not possible to notice malignant processes in time, the lymph nodes graduallygrow, which leads to the formation of large formations. At this stage, lymphoma almost always manifests itself as quite severe pain. Discomfort is especially pronounced if you drink alcohol.
There are cases when Hodgkin's lymphoma was detected quite by accident during a routine fluorography, since the enlarged nodes did not respond with pain and did not bring the patient anxiety, did not attract attention. Perhaps they have already provoked shortness of breath and cough, but patients rarely pay attention to such manifestations. As the situation progresses, the enlarged lymph nodes press on the superior vena cava, causing the face to swell and the skin to become bluish.
Development: many scenarios
Characteristic symptoms of Hodgkin's lymphoma (activation of sweating, weight loss, fever) at the initial stages of the disease appear only in 15% of patients. In the predominant percentage of cases, an increase in lymph nodes and symptoms characteristic of the disease come later, as the pathology progresses. Lymphoma is often accompanied by anemia, leukopenia. Doctors note that fever in oncological disease is different. Most often, patients are disturbed by short-term bouts of heat, followed by chills and sweating. Such situations can be repeated every day or even several times a day. To alleviate the condition, many use:
- Indomethacin.
- Butadion.
The development of the disease in every third patient leads to damage to the spleen. atypical cellsspread to other systems. There are cases when malignant processes affected the tonsils, pharyngeal tissues, but this occurs in a relatively small percentage of cases.
If, during the process, atypical cells hit the lungs, infiltrates form, cavities appear, cells from the lymph nodes gradually spread into the mediastinum, and the pleural areas become the localization of fluid accumulation.
The pleural lesion in lymphoma can be detected by taking an x-ray. Atypical cells are found in the liquid during analysis. From the mediastinum, the process can spread to the esophagus, cardiac tissue, and trachea.
In one case out of five, the process affects the bone tissue. The most vulnerable are the sternum, spine, ribs, and hip bone system. Somewhat less often, atypical cells penetrate the tubular bones. If the disease has affected the musculoskeletal system, the patient is worried about severe pain.
Progress of disease
With Hodgkin's lymphoma, degenerate cells can spread to the bone marrow. Such changes are indicated by the quality of the blood: the concentration of leukocytes and platelets decreases. Possibly anemia. Some people don't have bone marrow symptoms even if the abnormal cells have affected the area.
When the liver is infected in the early stages, it is almost impossible to identify this fact due to the increased compensatory capabilities of the organ. If Hodgkin's lymphoma has spread to this area, the liver becomes larger, serum albumin decreases, and phosphatase becomes moreactive, but all these indicators can be detected only when conducting special studies aimed at confirming or excluding the fact of liver damage.
Secondary damage in lymphoma is possible in the gastrointestinal tract. Atypical cells are found in the submucosal layer. The process is not accompanied by the formation of ulcers.
There is a possibility of CNS infection. Research shows that abnormal cells can accumulate in the meninges of the spinal cord. This provokes neurological disorders, becomes the cause of absolute paralysis.
Almost every third patient with Hodgkin's lymphoma develops itching of certain areas of the skin, small rashes. In some cases, the manifestation is mistaken for dermatitis. Skin reactions are possible in the area near the enlarged lymph nodes, but reactions can unpredictably manifest themselves in other parts of the body. Itching is quite painful, leading to loss of appetite, sleep disturbance and mental disorders.
Blood tests for Hodgkin's lymphoma do not show any particular changes. In most, the concentration of leukocytes is close to normal, only in the later stages the number of these cells decreases.
